Friday, 6 June 2008

Dawn of the hand-scrub alcoholics

Nine calls; one cancelled on scene, one false alarm (time waster) and seven by ambulance.

An early start and a call to a 55 year-old male ‘fitting’ on the South Bank. He and his brother were waiting for us – he was lying on a bench going through the act of fitting and his brother explained, in broken English, that they were alcoholics and his brother had been off the booze for a few days, thus the fit. It all seemed well rehearsed to me and my cynical mind was cautious about the next step.

The MRU showed up and did very little except help with my obs; there wasn’t much else to do as the man jerked about on the bench, proving to us how ill he was. I wasn’t buying it and neither was my colleague. Neither did the ambulance crew when they arrived but, with no proof of deceit, he was taken to hospital and his brother wandered off without concern.


Later that day I was called to a 30 year-old male ‘collapsed’ in the City. He had a hospital band around his wrist and the police were on scene attending to him. I recognised him immediately as the ‘fitting’ man’s brother. He’d been in hospital on this side of town and discharged himself. Then he’d feigned collapse to obtain sympathy and another trip to hospital but this time he wasn’t getting it. The crew recognised him too; he was unlucky because he’d managed to draw attention to himself and the people who’d been called – myself and the same ambulance crew as earlier – knew what he was doing. Let me explain...

The man had a bottle of liquid on him and the police made a point of trying to identify what it was. At first it was thought he was carrying alcohol but he wasn’t – he had hospital cleaning fluid on him and he was drinking it. He and his brother had a little scam going; they’d both go to separate hospitals, as many times as possible in a day and steal as much cleaning fluid and hand gel as possible so that they could drink it and glean any alcohol from it. It’s happening more and more and the depth of this fairly new abuse has only just been brought to our attention.

He recovered very quickly when he realised we were on to him and he declined further aid (of course). I referred him to London Street Rescue in the hope that he could be taken off the street but he had a bad record with them and, although they told me they’d visit him to help, I didn’t expect he’d hang around for them. Both men are Lithuanian, neither work or contribute to the country and both are stealing resources openly and without punishment. Can I really be labelled racist for venturing the opinion that we should no longer tolerate such abuse from people we invite into this country for protection and a better life? There are plenty of foreign nationals here who contribute to our society and are part of it – Poles, for example – a few of them are drinkers and we visit them too but at least they are paying for the service!


I was cancelled on an earlier call for a 28 year-old male who fell from his bike when he started convulsing mid-cycle. The crew was on scene and I wasn’t required.


Then a 25 year-old man who was having ‘chest pain’ at a train station. He seemed a bit young for all that and I discovered that he’d actually had a fit and was slowly recovering by the time I got on scene. He was a nice chap (a film producer) and he hadn’t experienced a seizure for some time but was known to have them. He agreed to go to hospital so that they could work out a medical solution for him.


Another fitting person, this time a 30 year-old female, was on the floor of her office and had been convulsing for seven minutes, according to her colleagues. The crew was with me and an MRU arrived too and I got on with giving her diazepam as the oxygen was administered and obs were confirmed. Only after this had been done did her colleagues find out what her condition was; they had a letter stating that she was to be left alone and given nothing because she would recover on her own. On no account, the note said, was an ambulance to be called. Too late for that – they should have looked more closely at it when she gave it to them.


A 60 year-old man who had been arrested for stealing from his employer demanded an ambulance for chest pain and so I was asked to check him out. He told me he had angina and was suffering but he didn’t have his GTN with him and spent most of the time swearing and insulting the police for arresting him when there were ‘real crimes’ taking place out there. He wasn’t at all convincing but he claimed to have a history of MI (although he was vague about the date), so he was treated as genuine and carted off, with a police escort, to hospital.


My second chest pain call was to a shop where a 39 year-old member of staff felt dizzy, had abdo pain (and chest pain) and felt generally unwell. He told me he had a history of this but that nothing had been discovered by his doctors. He went to hospital and hopefully they’ll pinpoint the problem, otherwise he’s destined to go through life suffering.


Multiple Sclerosis is a devastatingly debilitating disease and my next patient, a 25 year-old man, was at home with his family, living with it but now there were other problems and he was vomiting and suffering kidney pains. His concerned mum called an ambulance because, despite putting up with the condition on a day-to-day basis, this was a new development and she feared something more acutely serious had struck.


I was late getting home because my last call took me back into the West End in rush hour. I was going to the aid of a 17 year-old girl who was hyperventilating at a large department store, where ironically, a number of past hyperventilating patients had demanded my attention – maybe it’s a stressful place to work.

It took ten minutes to calm her down and convince her that she wasn’t going to die. Her colleagues were pleased that she was getting better because they had been unable to slow her breathing down and I could hear her from a distance when I first arrived. She insisted on going to hospital ‘just in case it came back’ and I thought she might need to steel herself for life if this was how she generally went about dealing with her concerns. Yes, she’s only seventeen but life is cruel to young, vulnerable and sensitive people. How’s she going to deal with real crises in the future?

Be safe.

14 comments:

Hugh said...

I thought that they put bitrex in alcogel, to stop people doing that?

Xf said...

hugh

Yes, I belive this was tackled before but I don't think anyone told these guys and it's still a problem because they are finding other liquids in hospitals to do the job.

Anonymous said...

I have to agree entirely with your comment about these people that we, as tax payers, support.
I have always maintained that any foreigner should be deported back to thier country of origin if they commit a crime. Perhaps that would lessen the demand on our already over burdened ambulance staff, police, hospitals, jails, welfare benefits.......
I am not racist, I just hate injustice.

Button Ginger said...

The problem with devoted dipsomaniacs is that they can "drink through" the Bitrex.

George Best was drinking even though he'd been fitted with Antabuse pellets which when combined with alcohol makes the drinker feel very sick. That didn't stop him either.

Someone like that really can't be helped.

Hugh said...

Well if they ever start drinking it because of the smell - watch out for hospitals with the Braun stuff (green bottle) - its smells lovely.

miss emma said...

glad to have you back xf! hope you had a nice (well-deserved) rest and enjoy the weekend!
emma x

Anonymous said...

Great read xf.
Of the 1/2 dozen blogs I check out each week, your's is by far my favourite.

Sounds just like what I do (but I'm in the truck as we don't have FRU's here), but it sounds like you have a much greater problem with alcohol than we do in Tassie (not you personally).

G'day from an Aussie Paramedic.

Regards
Dave

dr_dyb said...

IIRc the new Royal Infirmary in Edinburgh had an alcoholic patient die after he drank the alcohol gel from the end of his bed. Now the GI ward has all its gel dispenser at teh nurses station.

Hugh said...

they make it in little personal bottles, with the extendable clips for staff - that should reduce the problem in areas like that.

Anonymous said...

1. Why did you need to give the 30 year old woman diazepam and oxygen if she was simply having a fit?

2. Was it an injection/IV?

3. Was this letter written by her own hand or was it by her doctor?

Years ago the advice given was that if someone was having an epileptic fit, you should put them in the recovery position with nothing in their mouth and leave them to ride out the fit. Why is it as in your blog that an ambulance seems to be called now?

Fiz said...

Yes, and people died! If you read Stuart's blog carefully, you'll see that "ambulance" now means taxi service, or a warm bed for the night!

Anonymous said...

Okay so some people died – I had never heard of this happening in the past. They may have died by people not knowing what to do or doing the wrong thing. So what has this to do with "taxi service" and "warm bed for the night”? The woman went as far as giving work colleagues a letter to say that on no account was an ambulance to be called. She clearly did not want a "taxi service" or a "warm bed for the night". Not only that but she was obviously having the kind of fit that did not require treatment so the Diazepam and oxygen were therefore unnecessary.

This advice had come from health visitors who regularly visited our school at the time, as well as an actual occurrence. Perhaps it was this kind of common fit that bystanders were given advice about. Anyway Stuart's blog is recent and that is how “patients” treat the service now. I am talking about days when people were more inclined to help each other without threat of being sued!

The woman clearly did not want an ambulance – full stop. A person should have the right not to have to be molested by ambulancemen.

And my three questions have still not been answered – preferably by Stuart who would know what actually took place; so I am asking him again –

1. Why did you need to give the 30 year old woman diazepam and oxygen if she was simply having a fit?

2. Was it an injection/IV?

3. Was this letter written by her own hand or was it by her doctor?

Years ago the advice given was that if someone was having an epileptic fit, you should put them in the recovery position with nothing in their mouth and leave them to ride out the fit so why is it that an ambulance seems to be called now?

Thank you.

Xf said...

anonymous

Sorry I have been so long answering your questions but they are actually best sent by email...you can probably see that I have little time to reply to all the comments and have yet to catch up.

Nevertheless, you are of course right, she didn't want to go to hospital, thus the letter but we didn't see that letter until we had gone through our procedure for ALL epileptic fits; oxygen, BM check, diazepam IV if still in seizure after a prolonged duration (7 minutes counts as prolonged).

This is standard procedure at my level...people have died for the lack of Diazepam, so the risk is there. I could be struck off for not giving it.

First aiders (unless trained) need only let the patient 'get on with it' if they absolutely know that the fit is limited to a certain duration and feel safe to allow it to continue but unfortunately, especially in London, nobody wants that responsibility, so they dial 999.

Her colleagues chose to ignore what her letter said and that's something I have no control over.

Xf said...

Dave

G'day mate...thanks!